参芪通络方联合康复训练对缺血性脑卒中偏瘫患者神经功能及残疾率影响

Effect of Shenqi Tongluo Decoction Combined Rehabilitation Training on Neurological Function and Disability Rate in Hemiplegia Patients with Ischemic Stroke

目的:研究参芪通络方联合康复训练对缺血性脑卒中偏瘫患者神经功能及残疾率的影响。方法:将我院2015年1月—2018年3月确诊的206例缺血性脑卒中偏瘫恢复期患者按随机数字表法分为两组(每组103例)。对照组患者给予基础治疗结合Brunnstorm康复训练,研究组患者在对照组的基础上加用参芪通络方。观察并比较两组患者神经功能缺损程度评定量表(NIHSS),Fugl-Meyer量表(FMA),改良Barthel指数(MBI)评分,血小板参数(血小板聚集率、血小板计数、平均血小板体积),中医证候评分及残疾率。结果:研究组的总有效率明显高于对照组,而致残率明显低于对照组(P<0.05)。治疗前,两组NIHSS、FMA、MBI评分比较差异无统计学意义(P>0.05);治疗后,两组NIHSS评分均明显降低,FMA与MBI评分均明显升高(P<0.05),且研究组NIHSS评分较对照组低,而FMA、MBI评分较对照组高(P<0.05)。治疗前两组患者各血小板参数比较无明显差异(P>0.05);治疗后,两组血小板聚集率与平均血小板体积均明显降低,血小板计数明显升高(P<0.05),且研究组患者血小板聚集率与平均血小板体积较对照组低,血小板计数较对照组高(P<0.05)。治疗前两组患者中医证候评分无明显差异(P>0.05),治疗后,两组中医证候评分均降低,且研究组明显低于对照组(P<0.05)。结论:参芪通络方联合Brunnstorm康复训练治疗缺血性脑卒中偏瘫能有效改善患者运动和神经功能,降低血液黏滞性,改善患者预后,降低残疾率,值得临床借鉴推广。

Objective:To investigate the effect of Shenqi Tongluo Decoction combined rehabilitation training on neurological function and disability rate in hemiplegia patients with ischemic stroke.Methods:206 hemiplegia patients with ischemic stroke in recovery stage treated in our hospital from January 2015 to March 2018 were selected and divided into two groups according to the random number table method,each with 103 cases.The control group received the routine treatment and Brunnstorm rehabilitation training,based on this,the study group received Shenqi Tongluo Decoction.Then various indicators were compared between groups,including National Institutes of Health Stroke Scale(NHSS),Fugl Meyer Assessment(FMA),Bathel Index(BI),platelet parameters(platelet aggregation rate,platelet count,mean platelet volume),TCM syndrome score and disability rates.Results:The total effective rate of the study group was significantly higher than that of the control group,and the disability rate was significantly lower than that of the control group(P<0.05).There was no significant difference in the scores of NIHSS,FMA and MBI between the two groups before treatment(P>0.05);after treatment,the score of NIHSS in both groups was decreased and the scores of FMA and MBI increased,and the score of NIHSS in the study group was significantly lower than that in the control group,and the FMA and MBI in the study group were significantly higher than those in the control group(P<0.05).There was no significant difference in platelet parameters between the two groups before treatment(P>0.05).After treatment,the platelet aggregation rate and mean platelet volume were significantly decreased and the platelet count was significantly increased in both groups(P<0.05).The platelet aggregation rate and mean platelet volume of the study group were lower than those of the control group,and the platelet count was higher than that of the control group(P<0.05).There was no significant difference in TCM syndrome score between the two groups before treatment(P>0.05).After treatment,the TCM syndrome score of the two groups was decreased,and the score in the study group was significantly lower than that in the control group(P<0.05).Conclusion:Shenqi Tongluo Decoction combined Brunnstorm rehabilitation training can effectively ameliorate the motor and neurological function,reduce blood viscosity,improve patient prognosis and reduce disability rate in hemiplegia patients with ischemic stroke,which is worthy of clinical promotion.